China

China is changing rapidly and further medical reforms are underway.

Rapid economic development in China has promoted medical reform. In China, with 1.2 billion people, the scale of hospitals is extraordinary. Konica Minolta image equipment for digital medical care has been introduced to many foundation hospitals with the latest facilities in major cities and has significantly contributed to the progress in medical services. We interviewed Peking Union Medical College Hospital, one of the organizations to whom we introduced our equipment and reported the latest circumstances of Chinese medical care.
(Report partner: Beijing Intech Housun Corporation)

Patient-Driven Cutting-Edge System Capable of Better Treatment

China is a country of 1.2 billion and 65 million people with a land area about 26 times larger than Japan. In October 2005, the National Bureau of Statistics of China announced that the rate of growth in the gross domestic product (GDP) from July to September in 2005 was 9.4% compared with the same period a year earlier. The phenomenal economic growth exceeded 9% for the 9th consecutive quarter and drew a lot of attention from all over the world. Trying to catch up with the dramatically developing economy, the government embarked on medical reforms with improvement of medical service as one of the most important policies, promoting disease prevention/countermeasure system establishment and emergency/treatment system development and reinforcement.

A premise of Chinese medical circumstances is that hospitals are ranked. There are three levels (3, 2, 1) and sublevels (A, B, C), and the highest rank is 3A. Hospitals ranked as Level 3A meet specific medical environment standards and are located in 800 places across the country under the direct jurisdiction of the Chinese Ministry of Health (equivalent to Japanese Health, Labor and Welfare Ministry) and the municipal Health Office. Hospitals ranked as Level 2 are under the direct jurisdiction of the lower section of the city or province class, and hospitals ranked as Level 1 are the town hospitals. The Peking Union Medical College Hospital (hereinafter referred to as the PUMC Hospital) we interviewed is ranked as 3A, the highest level.

The current administrative category representing jurisdiction over hospitals is classified as province level, prefecture level, county level, and township level. The province level is the first-class administrative area positioned just under the nation, for example, 23 provinces (including Taiwan), 5 autonomous areas (such as Nei Mongol and Tibet), 4 direct control areas (Beijing, Tianjin, Shanghai, and Chongqing), and the special administrative areas of Hong Kong and Macau. Each administrative area is subdivided into the prefecture level, county level, and township level in that order, but the names vary.

The medical insurance system is also very different between Japan and China. Personal medical costs were small until the 1980s in a system of complete welfare; however, the later medical reforms in 1998 introduced different systems depending on the occupation and place of residence, increasing the ratio of personal medical costs. It should be noted that although personal medical costs increased, expectations and demand for “better treatment in a better hospital” has been increasing. For example, at present, hospitals with a certain scale employs a system where the photos and career experience of enrolled doctors are posted in the lobby so that visiting patients can select whom to consult.

Ranking of physicians is an important element in the selection. Doctors in China are classified into entry-level, middle-level, sub-high-level, and formal high-level depending on the level of skills (refer to the table on the right).

About the Ranking of Physicians in China

Entry-Level Physician
Those who passed the national unified exam (occupational medical licensing exam) one year after graduating from school.

Middle-Level Physician
Those who passed the national health middle-class technical exam after working as an entry-level physician for five years.

Sub-High-Level Doctor
Those who passed the thesis exam and high-level physician exam after working as a middle-level physician for five years and were officially promoted after the probationary period required by the Health Office and senior organizations.

Formal High-Level Physician
Those who were officially promoted after working as a sub-high-level physician for five years.